Outcomes of the eTEP Approach for Incisional Ventral Hernia Repair: Initial Results from Can Tho General Hospital

Abstract Introduction: The extended-view totally extraperitoneal (eTEP) approach has emerged as an innovative technique for incisional ventral hernia repair, offering several advantages such as reduced postoperative pain, fewer skin-related complications, and improved cosmetic outcomes. This study aims to evaluate the early outcomes of the eTEP technique for incisional ventral hernia repair at Can Tho General Hospital. Patients and Methods: A retrospective study was conducted on 30 patients who underwent laparoscopic eTEP repair for incisional ventral hernias between June 2022 and February 2025. Patient demographics, hernia characteristics, surgical details, intraoperative and postoperative complications, postoperative pain scores (measured using the Visual Analog Scale VAS), and length of hospital stay were analyzed. Results: The mean age of the patients was 63.47 ± 12.76 years, with a mean BMI of 24.06 ± 3.55 kg/m 2 . Most hernias were located at the umbilical site (46.67%), and 90% were primary incisional hernias. The mean operative time was 164.5 ± 54.02 minutes, and the average hospital stay was 4.97 ± 2.89 days. Postoperative pain scores decreased significantly from 24 hours post-surgery (VAS 4.67 ± 1.35) to discharge (VAS 1.03 ± 0.32). Intraoperative complications were minimal (3.33%), while early postoperative complications included small bowel perforation (6.67%) and seroma formation (6.67%). The recurrence rate was 3.33% after a mean follow-up period of 18.9 ± 6.84 months. Conclusions: The eTEP approach for incisional ventral hernia repair offers promising early outcomes with low complication and recurrence rates, minimal postoperative pain, and short hospital stays. It represents a safe and effective minimally invasive option for appropriately selected patients. Keywords: eTEP, incisional ventral hernia, laparoscopic repair, initial outcomes. References Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener J, Chen DC, et al. Update of guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias. Surg Endosc. 2019;33(10):3069–3139. Badiger S, Koppad SN, Kulkarni A, Kodliwadmath H. Comparative analysis of open versus laparoscopic ventral hernia repair. Int Surg J. 2016 Aug;3(3):1167–1172. Aliseda D, Sanchez-Justicia C, Zozaya G, Lujan J, Almeida A, Blanco N, et al. Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (eTEP) approach: systematic review and meta-analysis. Hernia. 2022;26(6):1511–1520. Radu VG, Cucu DT. The eTEP/eTEP-TAR repair of ventral hernias: a study from one center/one surgeon—the first five years of experience. J Abdom Wall Surg. 2024;3:12796. Wieland L, Alfarawan F, Bockhorn M, El-Sourani N. Comparison of eTEP and IPOM for ventral hernia surgery in the early postoperative period: a retrospective cohort study of a tertiary university centre. Hernia. 2024;28(6):2195–2206. Daes J. Enhanced-view totally extraperitoneal access for repair of ventral hernias: advantages and liabilities. Cir Esp (Engl Ed). 2023;101(Suppl 1):S33–S39. Tryliskyy Y, Demykhova I, Kebkalo A, Vinnitskyi I, Kravchenko O. Minimally invasive extended totally extraperitoneal versus transabdominal retromuscular ventral hernia mesh repair: systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A. 2024;34(1):39–46. Li J, Wang Y, Wu L. The comparison of eTEP and IPOM in ventral and incisional hernia repair: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech. 2022;32(2):252–258. Belyansky I, Daes J, Radu VG, Balasubramanian R, Zahiri HR, Weltz AS, et al. A novel approach using the enhanced-view totally extraperitoneal (eTEP) technique for laparoscopic retromuscular hernia repair. Surg Endosc. 2018;32(3):1525–1532. Sanna A, Targa S, Mantovan B, De Luca M. The Enhanced-View Totally Extraperitoneal Repair for Ventral and Incisional Hernia: Midterm Results of an Evolving Technique. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2025 Jan;35(1):48–54. Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204(5):709–716. Download file PDF